{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:23:18Z","timestamp":1793146998766,"version":"4.5.0"},"reference-count":89,"publisher":"Korean Association of Internal Medicine","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["kjim.org"],"crossmark-restriction":true},"short-container-title":["Korean J Intern Med"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>Diabetic foot ulcers (DFUs) are among the most serious and common complications of diabetes mellitus. They significantly affect patients\u2019 quality of life and impose a substantial economic burden on healthcare systems worldwide. In Korea, the prevalence of diabetes and related complications, such as DFUs, has been increasing, reflecting a broader global trend. DFUs are associated with severe complications, including infections, neuropathy, and peripheral arterial disease, often leading to amputation. In Korea, diabetic foot complications are a major cause of non-traumatic lower-extremity amputations, with high mortality rates following amputation. DFUs also significantly reduce patients\u2019 quality of life and increase healthcare costs. The management of DFUs requires a multidisciplinary approach that integrates medical, surgical, and advanced therapeutic interventions to prevent severe outcomes, such as amputation. This comprehensive review of DFU management in patients with diabetes was developed in collaboration with the Diabetic Study Group of the Korean Diabetes Association and Korean Society for Diabetic Foot. This review examines the epidemiology, clinical significance, diagnosis, and evidence-based treatment of DFUs.<\/jats:p>","DOI":"10.3904\/kjim.2024.446","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T08:32:08Z","timestamp":1767342728000},"page":"47-59","update-policy":"https:\/\/doi.org\/10.3904\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Advanced strategies for the management of patients with diabetic foot ulcers: a comprehensive review"],"prefix":"10.3904","volume":"41","author":[{"given":"Ji Min","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong Hwa","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seon Mee","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Hwa","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Chun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanghyun","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Sun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0194-1665","authenticated-orcid":true,"given":"Ie Byung","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2270","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8050748"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2013.03.007"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2014.03.013"},{"key":"ref4","first-page":"3S","volume-title":"Global vascular guidelines on the management of chronic limb-threatening ischemia","author":"Conte","year":"2019"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-1816"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.175"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0536"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11406-3"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-1596"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239236"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-3120"},{"key":"ref12","first-page":"298","volume-title":"Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology","author":"Skyler","year":"2009"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9061780"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12196"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-010-0128-0"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-2244"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13682"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.01.060"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14840"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz489"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10173977"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.8399"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1027"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2176"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3657"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-s012"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2319"},{"key":"ref28","first-page":"1668","volume-title":"Muscle weakness and foot deformities in diabetes: relationship to neuropathy and foot ulceration in caucasian diabetic men","author":"van Schie","year":"2004"},{"key":"ref29","first-page":"1679","volume-title":"Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists","author":"Boulton","year":"2008"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.2.217"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-006-0491-1"},{"key":"ref32","first-page":"2021","volume-title":"Long-term prognosis of diabetic foot patients and their limbs: amputation and death over the course of a decade","author":"Morbach","year":"2012"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1016\/s0828-282x(10)70467-0"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2023.07.020"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.12.3333"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.1999.00523.x"},{"key":"ref37","first-page":"S1","volume-title":"Global vascular guidelines on the management of chronic limb-threatening ischemia","author":"Conte","year":"2019"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.2337\/diaclin.27.2.52"},{"key":"ref39","first-page":"e3648","volume-title":"Guidelines on the classification of foot ulcers in people with diabetes (IWGDF 2023 update)","author":"Monteiro-Soares","year":"2024"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.08.003"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1056\/nejmcp032966"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13512"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2020.107638"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2018.09.021"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.10.005"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-05020-7"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd001488.pub5"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2018.e00614"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1086\/644732"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.3390\/medicina55110714"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3266"},{"key":"ref52","first-page":"7","volume-title":"Diabetic foot infections","author":"Bergman","year":"2016"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2015.1021780"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-017-0831-1"},{"key":"ref55","first-page":"e3687","volume-title":"IWGDF\/IDSA guidelines on the diagnosis and treatment of diabetes\u2013related foot infections (IWGDF\/IDSA 2023)","author":"Senneville","year":"2024"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3283"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15544"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.825"},{"key":"ref59","first-page":"S207","volume-title":"10. Cardiovascular disease and risk management: standards of care in diabetes-2025","year":"2025"},{"key":"ref60","first-page":"1319","volume-title":"Rivaroxaban with or without aspirin in stable cardiovascular disease","author":"Eikelboom","year":"2017"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.12701\/jyms.2023.00682"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3251"},{"key":"ref63","first-page":"2473011418788864","volume-title":"The evaluation and treatment of diabetic foot ulcers and diabetic foot infections","author":"Del Core","year":"2018"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.3390\/molecules22101743"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2022.105581"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2204"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1086\/383268"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1016\/j.mporth.2019.03.005"},{"key":"ref69","first-page":"392","volume-title":"Hyperbaric oxygen therapy does not reduce indications for amputation in patients with diabetes with nonhealing ulcers of the lower limb: a prospective, double-blind, randomized controlled clinical trial","author":"Fedorko","year":"2016"},{"key":"ref70","first-page":"84","volume-title":"A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems","author":"Oyibo","year":"2001"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-8-201310150-00006"},{"key":"ref72","first-page":"42","volume-title":"Energy cost of walking of amputees: the influence of level of amputation","author":"Waters","year":"1976"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.1016\/s0966-6362(99)00009-0"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.27245"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v14.i5.312"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2021.03.017"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2016.10.023"},{"key":"ref78","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.118.006778"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.11.022"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.1177\/15385744211022598"},{"key":"ref81","first-page":"31","volume-title":"Endovascular procedures and new insights in diabetic limb salvage","author":"Peeters","year":"2012"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.01.066"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2021.10.035"},{"key":"ref84","doi-asserted-by":"publisher","DOI":"10.23736\/s0392-9590.17.03866-4"},{"key":"ref85","first-page":"2305","volume-title":"Surgery or endovascular therapy for chronic limb-threatening ischemia","author":"Farber","year":"2022"},{"key":"ref86","doi-asserted-by":"publisher","DOI":"10.1177\/15385744221086347"},{"key":"ref87","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.10.085"},{"key":"ref88","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2009.12.002"},{"key":"ref89","first-page":"e132","volume-title":"2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections","author":"Lipsky","year":"2012"}],"container-title":["The Korean Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/kjim.org\/upload\/kjim-2024-446.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2024.446","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/upload\/kjim-2024-446.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T04:45:47Z","timestamp":1768193147000},"score":1,"resource":{"primary":{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2024.446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":89,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.3904\/kjim.2024.446","relation":{},"ISSN":["1226-3303","2005-6648"],"issn-type":[{"value":"1226-3303","type":"print"},{"value":"2005-6648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]},"assertion":[{"value":"2024-12-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-01","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}